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NPI Code Detail

MEDICARE: YMGA PHARMACY SERVICES, CORP

MEDICARE: YMGA PHARMACY SERVICES, CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy025286NY
23336C0003XCommunity/Retail Pharmacy025286NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891784948
Entity Type Code : Organization
Provider Name (Legal Business Name) : YMGA PHARMACY SERVICES, CORP
Provider Business Mailing Address
First Line : 8510 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4610
Country : US
Telephone Number : 718-680-9855
Fax Number : 718-680-9856
Provider Business Practice Location Address
First Line : 8510 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4610
Country : US
Telephone Number : 718-680-9855
Fax Number : 718-680-9856
Authorized Official
Title or Position : PRESIDENT
Name : ANTON FALLAH
Credential : RPH
Telephone Number : 718-680-9855
Provider Enumeration Date : 10/20/2005
Last Update Date : 11/18/2013

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